Mother-to-Child hiv transmission prevention

Of all our programs, “Chez Rosalie,” our Mother To Child Transmission Prevention program (MTCTP) at the Sikoro Clinic enrolls the largest amount of HIV+ patients. We have screened over 10,000 pregnant women since its establishment in 2005. Our midwives have tested 99% of all women seen for prenatal care and all (100%!) of their babies have been born HIV free. These rates far exceed those from 338 other prenatal clinics in Mali where, on average, only 31% of pregnant women are tested for HIV.

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Our doctors and midwives have demonstrated over the years that through healthcare personnel training and support, it is possible to create an environment where consistent counseling, HIV testing, and access to care, work to eliminate mother-to-child transmission!

In fact, the impact of the technical assistance provided by GAIA in Sikoro has been profound: The prevalence of HIV infection among young women has dropped farther and faster than the prevalence rate in the rest of the city. The trend of reduction of HIV seroprevalence in Sikoro accelerated following introduction of MTCTP (prevalence of 4.3%), as compared to the national HIV prevalence in Mali. We believe that early introduction of MTCTP by GAIA lowered the HIV prevalence rate among new mothers in Sikoro.

 

GAIA statistics from the “Hope Center Clinic (Sikoro) vs. Malian national statistics (UNAIDS 2006-2015).

 

Adjiaratou shares a meal with her HIV-free daughter Fatoumata at the clinic support program lunch.


Number of women seen for prenatal care, number of women who accepted and HIV testing. 2016 rates are projected based on 10 months of data.

Number of women seen for prenatal care, number of women who accepted and HIV testing. 2016 rates are projected based on 10 months of data.

Over the 10-plus years that we have been providing MTCTP at the Hope Center clinic, the 99% test acceptance rate has remained consistent. Since 2012, there has been a very slight decline in prenatal care rates. This is potentially due to the fact that public health officials began to limit the activities of matronnes (traditional birth attendants) and prioritize the work of conventionally trained midwives.  Many matronnes are providing “freelance” homebirths, which lowers the rate of clinic registered births – this may have an impact on the rates of testing and treatment seen above. We plan to equip the matronnes with HIV testing and treatment capability in 2017. 



As part of GAIA’s mission, not only do we provide much needed health care, but we have also completed a recent study that will help form effective future MTCTP programs. The study demonstrates the success of our program at preventing “vertical transmission” (HIV transmission from mother to infant) even in a low-cost setting. By offering free screenings to pregnant women, confidential counseling, ARV treatment for women during pregnancy and infants after birth, we are able to significantly reduce to risk of babies born to HIV+ mothers, as well as improve the health of the women themselves. This study allowed us to confirm our patients’ satisfaction with the "Chez Rosalie" program and reiterate that PMTCT programs act as a potent weapon in the fight against HIV.